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NPI Code Detail

MEDICARE: BLEND MARIE REYES

MEDICARE: BLEND MARIE REYES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistP49710NY
2106S00000XBehavior TechnicianRBT-23-281314NV
3106S00000XBehavior TechnicianRBT3558NV

General Provider Information

NPI Number : 1942232434
Entity Type Code : Individual
Provider Name (Legal Business Name) : BLEND MARIE REYES
Provider Business Mailing Address
First Line : 5575 SIMMONS ST STE 1-491
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89031-9009
Country : US
Telephone Number : 702-476-2633
Fax Number : 702-979-1028
Provider Business Practice Location Address
First Line : 7560 W SAHARA AVE STE 107
Second Line :
City : LAS VEGAS
State : NV
Zip : 89117-2745
Country : US
Telephone Number : 702-476-2633
Fax Number : 702-979-1028
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/06/2023

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Directions to “ BLEND MARIE REYES ” Practice Location

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